Vaginal Infections (Vaginitis)

Vaginal infections happen to women of all ages, regardless of whether they have had sex. Most women have a vaginal infection at least one time during their lives. Vaginal infections are actually the number one reason that adult women see their health care providers.

What is normal discharge?

Most girls notice a yellow or white stain on their underwear after they go through puberty. This is a normal fluid that helps clean and moisten your vagina. You are completely healthy and normal if your discharge is cloudy white, has no odor or has a slightly salty odor, and is white or light yellow when it dries on underwear. It is normal for vaginal discharge to increase in amount and become “stringy” (like egg whites) during the middle of your menstrual cycle when you’re ovulating.

If you find that your normal discharge is annoying, you can wear panty liners/shields on your underwear. Also, to keep your vaginal discharge under control, make sure you wear cotton underwear (which absorbs moisture and lets air circulate). Take daily showers or baths and make sure that you wash your vulva (outside of your vaginal area) every day with mild soap and water, and then rinse and pat dry with a clean towel. Don’t use deodorized panty liners or deodorant sprays in your vaginal area.

If your discharge changes, it may be a sign that you have a vaginal infection. You’ll need to make an appointment with your health care provider so that you can get checked and treated if necessary.

What is a vaginal infection?

A vaginal infection is known medically as “vaginitis.” The 3 most common causes of vaginal infections are yeast infections, bacterial vaginosis, and trichomoniasis. Vaginal discharge may also occur if you have an infection in your cervix with gonorrhea or chlamydia. There are other causes of vaginal infections that are less common. Each type of vaginitis is caused by a different type of germ or organism, so each type must be treated differently.

What are the signs/symptoms of a vaginal infection?

If you have a vaginal infection, you may have any of the following:

• Vaginal discharge that is different than you usually have
• Vaginal odor (smell)
• Vaginal itching or irritation
• Pain or irritation when you urinate (pee)
• Pain and/or burning with sexual intercourse
• Bleeding or spotting

Most women have symptoms, but some women may have very mild or no symptoms at all. A health care provider may notice signs of a vaginal infection (such as discharge or an odor) during a routine pelvic exam and then test the vaginal fluid to see if there is an infection. It’s important to have regular check-ups with your health care provider so if you miss something, he/she may notice it.

What do I do if I think I have a vaginal infection?

If you have any of the symptoms of a vaginal infection, you should see your health care provider right away. Each kind of vaginal infection has different symptoms. It’s hard to know exactly which type of vaginal infection you have just by your symptoms alone, since many of the signs are similar. It’s also possible to have more than one type of vaginal infection at the same time. Only health care providers can find out if you definitely have a vaginal infection, an STI, or another diagnosis– that’s why it’s important not to try to treat the symptoms yourself. You should be completely honest with your health care provider about what symptoms you have, such as odor, burning, or strange vaginal discharge, even if it is embarrassing. This way, your health care provider can make a correct diagnosis and prescribe the right treatment.

Can I douche if I have a vaginal infection?

No. You should never douche! Douching can cause infections by changing the normal balance of organisms in your vagina. Douching can also make an infection worse if you already have one, push the infection up into your uterus and fallopian tubes, or hide symptoms of a vaginal infection so it’s harder to diagnose. Other things that can cause vaginal infections are scented tampons, deodorant sprays, and harsh soaps. Your vagina cleans itself naturally. You don’t need to buy any special products, just wash the outside of your vagina (vulva) with mild soap and water, and pat dry. Do not place soap or lotions into your vagina.

How can a health care provider tell if I have a vaginal infection?

A sample of your vaginal discharge will be taken with a cotton swab to be used for testing. Your health care provider can look at it under a microscope and to check the pH in the office and/or send the sample to the laboratory for special tests. This may mean just an external exam with Q-tip samples, or it may mean a vaginal exam with a speculum (a metal or plastic instrument inserted into your vagina and then slightly opened up in order to get a better look at your vagina and cervix). The tests are very simple and quick.

Does my health care provider check to see if I have a vaginal infection when he/she does my Pap test?

If the symptoms, such as discharge or odor are visible on the outside of your vagina, your health care provider will do some tests to see if you do have a vaginal infection. However, you should still make sure to tell your health care provider if you’re having symptoms. A Pap test is done to check for changes in the cells of your cervix that can lead to cervical cancer (not for diagnosing vaginitis), but sometimes signs of vaginitis show up on the Pap test results. If this happens, you may get a call or letter from your HCP letting you know that you have a vaginal infection along with treatment instructions.

How is a vaginal infection treated?

The treatment depends on the cause of the vaginal infection. If your symptoms are caused one of the 3 most common types of infection, you may be treated with an oral (by mouth) or topical (applied inside the vagina) antibiotic or antifungal medication. If the cause of your infection is an STI, your partner will also need to be treated.

What can I do to keep my vagina healthy?

Work on good feminine hygiene and follow safer sex practices.

• Keep your vaginal area clean and dry. You should wash the outside of your vaginal area every day with mild soap and warm water, and then rinse well. Be sure to pat the area dry with a clean dry towel.
• Don’t douche. Douching can upset the normal balance of organisms in your vagina, which can cause a vaginal infection, make an infection worse, or spread the infection further up into your reproductive organs (your uterus and/or fallopian tubes).
• Don’t use perfumed soaps, perfumed bubble bath or gel, scented tampons, vaginal powders, or vaginal deodorant sprays. These products can irritate your vagina and vulva. If your vaginal area is already irritated, you should not use scented toilet paper, spermicides, or harsh soaps.
• Don’t wear tight or damp clothing. Both tight and damp clothing such as underwear, shorts, pants or bathing suit can keep moisture in and irritate your vagina. If you have to wear tight clothing, don’t wear it for a long time. Consider wearing white cotton underwear instead of underwear made of nylon and lycra. Cotton helps to absorb moisture and allows air to get through. If you wear pantyhose, remember to wear cotton underwear.
• Practice safe sex.You shouldn’t have sex with someone with a sexually transmitted infection. No matter what, you should always use latex (or polyurethane) condoms to lessen your chance of getting sexually transmitted infections (STIs).
• If you use diaphragms, cervical caps, or any medication applicators, you need to make sure you clean them with warm water and soap and dry them well before storing them.

Other causes of vaginal infections: There are other causes of vaginal infections besides the 3 most common causes, yeast infections, bacterial vaginosis, and trichomoniasis. Other possible causes may include sexually transmitted infections (STIs), a tampon left in too long, a congenital vaginal or uterus problem (something you have since birth, which is very rare), or an allergy or irritation from:

• Spermicides
• Vaginal hygiene products
• Detergents
• Fabric softeners

These products can cause irritation to the vagina and vulva. When a health care provider does tests on your vaginal discharge, they can figure out if your symptoms are caused by one of the 3 more common causes of vaginal infections or if there is a different cause that requires a different treatment. You should always see your health care provider if you notice symptoms of a vaginal infection or your discharge is different for you.

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Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.